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North East Ambulance Service

Volume 476: debated on Tuesday 20 May 2008

I have been trying to secure this debate for several months, and am very happy that I have now been able to do so. I would like to put on the record my thanks to Mr. Speaker for giving me the opportunity to raise this very important issue. I am also very pleased to see the Minister in her place. It will be the first time since she was appointed as a Minister that she will have responded to one of my debates. I praise her for all the good work that she is doing in the Department of Health.

Right hon. and hon. Members representing constituencies in Tees valley, some of whom are present, support the cause that I want to articulate today. I also have the strong support of all local councils in the Tees valley area.

I wish to speak about plans by the North East Ambulance Service NHS Trust to reconfigure its ambulance control rooms. The trust covers the whole of the north-east and, in Teesside, includes the whole of the former Cleveland county area. I make no criticism of any of the hard-working staff; my concern is about management proposals to alter the control arrangements. Currently, the NEAS structure has two command and control centres: one in Newcastle, operating out of Bernicia house—the NEAS headquarters in Newcastle business park—and one in Middlesbrough serving as a satellite centre to Newcastle and covering the old Cleveland county council area.

The Middlesbrough centre, which employs 25 staff, is based at Cleveland police headquarters in Coulby Newham, in my constituency. Close links have been developed with the existing Newcastle centre, and the technology is such that the Newcastle centre can act as a back-up for the Middlesbrough centre in call handling and ambulance dispatching. In a sense, therefore, we have an arrangement that functions well, and which meets the current need. However, the demands of the ambulance service are evolving. In particular, over the past few years, there has been an increasing demand on ambulance services, partly as a result of changes to out-of-hours coverage by general practitioners.

In that context, the demands by the Department for all ambulance trusts to install new digital radio communications systems had to be considered by the NEAS, as did the need to plan for heightened civil resilience in light of continuing terrorist threats. Those demands led the NEAS to set up a review of its own control and command facilities. However, I believe that it has come to a conclusion that is potentially damaging to the service provided in Teesside. It started by considering what form of configuration is needed to meet Department of Heath challenges.

On the basis of operation effectiveness, risk and cost, it came to the following conclusions. The first was that a single centre could be operationally effective and cheaply built, but face a high risk of disruption, through a technical breakdown, natural disaster or terrorist attack. The second conclusion was that, although having three or more centres would reduce the risk in such circumstances, the configuration could be confusing in an emergency. It decided, therefore, that having two independent, but linked centres was the option to pursue. It argued that such a configuration would be robust when dealing with risk or attack at one location. The second location could easily increase its level of service through shared software infrastructure. If built correctly, it could physically accommodate staff from the affected centre, which would, I believe, provide an effective service for the benefit of local people and for local hospitals. Looking at those options in the same manner, I would have come to the same conclusion.

That issue having been resolved, the next question was where best to locate the two centres, which is where our views diverge. The NEAS looked at possible locations across the whole region, including the current centres in Newcastle and Coulby Newham in Middlesbrough. It argues that a key factor that it had to consider was the need to conform with the requirements of the Civil Contingencies Act 2004. One requirement is that when planning for control and command resilience, split sites able to assume back-up

“should ideally not share common utility services”,


“be between 15 miles and one hour’s journey from the main, or affected, site”.

On that basis, and on the ability to redeploy staff, the NEAS decided that its preferred option for two centres would be its control room in Newcastle and a second centre, 10 miles away, at Hebburn on south Tyneside.

I do not disagree that the main Newcastle control room should be one such centre—that is operationally logical—but I question the possible location of the second centre, which, for the following reasons, should be on Teesside. First, we already have dedicated staff at Coulby Newham, and relocating to Tyneside would add up to two hours daily travelling for those living south of Coulby Newham or in areas such as Stokesley, Redcar or east Cleveland, which could reduce operational ability in facilitating staff shift handovers. Secondly, there has been an offer from Cleveland police for the centre to be operated from force premises, which would either be at the existing centre at Ladgate lane or at a newly built facility for any future move. There is little evidence, however, that that offer has been carefully considered.

Thirdly, the close proximity of the two proposed centres poses risks. Both rely on the same utilities for electricity and telephone lines. I gather that most major telephone trunk lines on Tyneside radiate out on a hub and spoke basis from central Newcastle. If a major incident were to happen in Newcastle, therefore, the outlying exchanges serving the Newburn and Hebburn areas could be cut off from each other. Likewise, although I am not certain about the pattern of high voltage distribution in Tyneside, I suspect that the same pattern might be replicated in that utility area. That would not be the case for Teesside, which is in an entirely different trunk route and telephone route, and relies on differing national grid connections.

My single biggest objection, however, is that Teesside has one special characteristic that demands an ambulance control room presence in this sub-region. Teesside is one of the global centres for chemical production with almost all the key global players having plants in the area. It deals with the processing and shipping in and out of millions of tonnes of volatile and highly flammable chemicals every year. It also has two major power stations—one gas fired and one nuclear, the latter of which is in the constituency of the Under-Secretary for Communities and Local Government my hon. Friend the Member for Hartlepool (Mr. Wright). It is probably the one nuclear power station in the UK that lies close to a densely populated area. Teesside also has Europe’s deepest mine—the Boulby potash mine, which is in my own constituency.

We have never had a major industrial incident on Teesside, but the raw materials for such an incident are there in quantity. Together with the rest of the UK, Teesside now faces the threat of terrorism. In that context, it is inconceivable that potential terrorists would overlook industrial targets of opportunity. Indeed, at one recent trial, evidence showed references to Teesside on a possible hit list. Given that heightened threat, it is clear to me that traditional joint working of all three emergency services on Teesside needs to be maintained. That must allow for a focused and localised response to all the dangers and challenges that Teesside could face. That approach has been overlooked by the NEAS.

The Cleveland emergency planning officer, Mr. Dennis Hampson, in a report presented to an emergency planning joint committee earlier this month, said that the NEAS proposal

“has the potential to make the Cleveland area less resilient.”

He went on to say that it could cause

“a loss of local knowledge of control room staff.”

On the point of local knowledge, will my hon. Friend accept that, to date, the consultation with users and staff has been abysmal, and that the consultation with the local authority scrutiny committees has been lamentable? I have asked a series of questions about the problems that we would face on Teesside should the move take place, and they have not been answered. My hon. Friend is outlining the dangers that are there and I am saying that the consultation has not been full enough or sensibly carried out. Therefore, if, at the end of this, a decision is taken to move our Teesside ambulance services to Tyneside, we will ask the national health service’s reconfiguration panel to reconsider the whole process in the belief that the decision will be changed and the ambulance service will be left on Teesside.

I agree with every word that my hon. Friend has said. In fact, I think that she has been looking over my script because that is exactly what I was going to say. I totally agree with what she said about the consultation. Many staff have said similar things to me.

Mr. Hampson also said that there was

“a need for specialist knowledge of how ambulance accident and emergency crews should respond to chemical and nuclear incidents.”

That view has also been echoed by the local council, through the health scrutiny committees and the Cleveland joint emergency planning unit. The overview and scrutiny powers of local councils are crucial in that respect. However diligent or effective the NHS trust is, it is still an appointed trust. Local councils and local councillors are directly elected. Therefore, members serving on the health overview and scrutiny committees reflect the views of their communities. They can refer matters to the Secretary of State on the grounds that the consultation on changes by the NHS trust is flawed or not in the best interests of the public. The Secretary of State can then refer the issue to the independent configuration panel for an overarching reassessment and, if necessary, a full review.

I understand that the NEAS board is meeting on 22 May and that its proposals remain unaltered. It is clear that if the proposal is approved by the board, the matter will be referred to the Secretary of State. I then expect the proposals to be passed as a matter of urgency to the independent configuration panel, which would take on board the views of the other emergency services on Teesside. That would allow us to build an ambulance control service that truly represents the people and the needs of Teesside.

In the 11 years that I have been a Member of Parliament, I have always supported the Government. I have never even abstained on an issue. If the Government go ahead with the proposal, there will be consequences in the future. We are rushing into a zone in which we should not be. I appeal to the Minister to consider my biggest objection to the proposal regarding Teesside and its chemical plants. In the end, the buck will stop with her or the Secretary of State. The Minister knows the area very well, and I appeal to her to take note of what I have said. She knows that I have the support of all Tees valley Members on this issue, and I hope that she will give a positive response.

I congratulate my hon. Friend the Member for Middlesbrough, South and East Cleveland (Dr. Kumar) on securing this debate, which he has wanted for some time. He has shown an active interest in the organisation of ambulance control rooms and other health issues in the north-east, and I commend the dedication with which he serves the needs of his constituents. The same is true of my hon. Friend the Member for Stockton, South (Ms Taylor) and the Under-Secretary of State for Communities and Local Government, my hon. Friend the Member for Hartlepool (Mr. Wright) who are present today and other hon. Members who were unable to be in the Chamber for this very important debate.

I recognise that there has been considerable public interest in the control-room organisation of the North East Ambulance Service NHS Trust. I welcome the opportunity to respond to those concerns and to try to give some reassurance. I must stress, though, that the decision on the proposals for the location of control rooms to which my hon. Friend referred has not yet been made. I understand that the trust board is due to make the decision at a meeting on 22 May, so it would be inappropriate for me to comment on the specifics of the case at this time. However, I hope that an explanation of Government policy on ambulance provision may address some of my hon. Friend’s concerns.

I want to stress that the Department of Health expects all ambulance trusts to ensure that their control rooms are fit for purpose. It is their responsibility to make sure that control rooms have the capacity, capability and resilience to deal with the needs and demands of the local area. I am referring here to the needs and demands that my hon. Friend the Member for Middlesbrough, South and East Cleveland has raised in the debate. The changes being made in the NEAS should be considered within a much wider programme of improvements in ambulance provision.

In 2005, the Department published an ambulance review, which made a number of recommendations to transform the ambulance service. To support those improvements and following a consultation, the number of ambulance trusts was reduced to 12 broadly to reflect strategic health authority boundaries. As a result of the merger, some trusts needed to streamline and improve their operations. It is right and proper that the decisions about local services are made at a local level, but, in order to support the trusts through this process, the Department of Health commissioned a review of ambulance control rooms to provide it with an overview on a range of control-room issues.

The review concluded that the needs of the English ambulance trusts would probably be best served by adopting a small number of multiple sites—a minimum of two—with each site complying with a range of minimum standards outlined in the report. There was no single recommended operational configuration, but a series of options for trusts to consider. The review made it clear that within overall best practice, it was for the trusts to determine their own control-room organisation. Trusts considering control-room changes need to make their own decisions locally about how to meet the needs of their populations and their own operational challenges.

I have been advised by the trust that the current position for ambulance provision in the north-east is not sustainable for a number of reasons. In the north-east, NHS Direct provides back-up to the ambulance service, which is not the most appropriate solution. In addition, the control room in Middlesbrough can manage only 60 per cent. of 999 calls originating in the Tees area. The proposals that the board is deciding on aim to ensure resilience and business continuity in those areas.

Does my hon. Friend accept that Cleveland police has offered greater space to the ambulance service should it require it. Frankly, I do not think that the greater space has been considered.

I will go on to inform my hon. Friend of some of the progress that has been made in that area.

In identifying proposals for the north-east, the trust drew on the national control room review, but also employed a consultancy to evaluate a number of existing and potential new sites for its control centres. The consultancy provided a set of independent recommendations that were shared with all stakeholders prior to a formal consultation. Five proposals were outlined in the consultation. I understand that the NEAS preferred the option of establishing two independent contact centres. It believed that that would best achieve continuation of service and provide adequate contingency in case of emergency.

I believe, however, that two further proposals have been suggested during the consultation period. One, suggested by Cleveland police, was that the facilities at the control room in Middlesbrough should be extended to make it an independent contact centre. The second was put forward by my hon. Friend the Member for Stockton, North (Frank Cook), who is not in his place. He suggested that the second contact centre be located in Wynyard. I commend Cleveland police and my hon. Friend on their interest and engagement in the matter, and I believe that both options will be considered by the board alongside all the others.

The NEAS has made it clear that it views its proposals as having been drawn from extensive investigations by independent and nationally recognised industry experts in emergency service control rooms. They are intended to achieve the best possible resilience and an uninterruptible emergency service, and to make the most of technological and medical advances.

The role of the Department of Health and the Secretary of State in local reorganisation is rightly limited. If my hon. Friend the Member for Middlesbrough, South and East Cleveland and others still have concerns once the board’s decision has been made, I advise them to make every effort to resolve them with the NEAS. Should it be necessary, the second course of redress would be to raise concerns with the local authority’s overview and scrutiny committee. If that committee wished to contest the proposals on the basis that the consultation was inadequate or that they were not in the interests of the health service, it could refer the case to the Secretary of State. The Secretary of State would then ask the independent reconfiguration panel to undertake an initial assessment to determine whether a full review was needed.

I have been reassured by the NEAS that it is keen to avoid redundancies. My hon. Friend mentioned the potential loss of not only jobs but expertise, which is vital to the service. It is keen to avoid any such redundancies, regardless of the board’s decision about the reorganisation of the control rooms. The trust has been in close contact with the unions, and I am assured that it will hold one-to-one interviews with staff to discuss the options available once a decision is known. I encourage the trust to continue to support its staff through the period of change, particularly while waiting for decisions. Once decisions have been made, I encourage it to acknowledge the knowledge and expertise in the area.

I wish to put on record the point that if staff from the Tees are moved to the Tyne, they will be asked to increase their day by at least two hours, without pay. That is a totally unacceptable request.

I take my hon. Friend’s comments seriously, and I shall ask officials to look into that and inform myself and the Minister responsible for the ambulance service. I acknowledge the request that she has made of us.

I recognise that patients and the public feel very strongly about the organisation of ambulance control rooms. As a former nurse who worked in the health service for more than 25 years, I am fully aware of the commitment of our control room staff and ambulance crews and the debt that we owe to such skilled and highly professional people. Understandably, people want to feel secure in the knowledge that the services that they need will be there for them at times of life-threatening emergency.

My hon. Friend the Member for Middlesbrough, South and East Cleveland has outlined the seriousness of what faces us all, including the threat of terrorism, particularly to the chemical plants in the area. My understanding is that no decision has been made about where any future control room would be located. The area is important to all of us—including its football team, Middlesbrough. I would be failing in my duty as the chairman of the all-party group on football if I did not give it a mention. I reassure my hon. Friend that rather than compromise the services there, the Government are committed to making services better, not worse, for patients and ambulance staff at every level.

I note the comments that have been made, and I shall take them back to officials. However, I reinforce my point about the procedure that is open to hon. Members. I hope that the decision to be made by the NEAS board on 22 May will provide a robust ambulance service that meets patients’ needs both in my hon. Friend’s constituency and across the north-east. They deserve to have that.

Question put and agreed to.

Adjourned accordingly at five minutes to Two o’clock.